| NPI | 1225446842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3362) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: KY TC101) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2024-04-30 |