| NPI | 1194421867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3263) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 261QU0200X Clinic/Center, Urgent Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: KY PA3263) | |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2024-09-05 |