| NPI | 1306316989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2415) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003733A) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2023-08-16 |