| NPI | 1134558927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC246) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002065) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2019-10-02 |