| NPI | 1336832880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004244A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3409) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2024-11-05 |