| NPI | 1306417993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2906) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2022-04-18 |