| NPI | 1265960504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA229) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC590) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2023-09-27 |