| NPI | 1326296815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2299) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 012103) |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA2299) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA2299) | |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2023-02-22 |