| NPI | 1356328231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 55001096) |
| 363A00000X Physician Assistant (Licence: IN 10004353A) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2024-09-23 |