| NPI | 1255721700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2363) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005643) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2022-04-22 |