| NPI | 1144370875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002405L) |
| 363A00000X Physician Assistant (Licence: FL PA9101591) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |