| NPI | 1154714608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1994) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC367) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2024-02-28 |