| NPI | 1346345667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KY PA539) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: KY 3126) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-12-02 |