| NPI | 1295612885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC084) |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-10-31 |