| NPI | 1265789671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY 1106559) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1768) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2023-09-29 |