| NPI | 1326597139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA3192) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10004103A) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2023-09-08 |