| NPI | 1205664968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3645) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY 1208448) |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2025-08-22 |