| NPI | 1336863166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3243) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004305A) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2024-04-02 |