| NPI | 1275028011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08163) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2023-12-04 |