| NPI | 1326473851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC057) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004037) |
| 363A00000X Physician Assistant (Licence: LA PA. 200650) | |
| 363AM0700X Physician Assistant, Medical (Licence: KY TC057) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY TC057) | |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2025-07-18 |