NPI | 1326326935 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA525) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA1926) |
Enumeration Date | 2011-07-30 |
Last Update Date | 2022-02-10 |