| NPI | 1205303625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC877) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 103G00000X Clinical Neuropsychologist | |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2020-10-19 |