| NPI | 1255949814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2721) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2024-08-08 |