| NPI | 1295118206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC388) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 2713) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2023-09-11 |