| NPI | 1225038086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA816) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2024-08-27 |