| NPI | 1134764574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA064141) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: KY PA2604) | |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2023-08-28 |