| NPI | 1205526464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC041) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2023-11-02 |