| NPI | 1356391031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC176) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002996) |
| 363A00000X Physician Assistant (Licence: IN 10004198A) | |
| 363A00000X Physician Assistant (Licence: AZ 3308) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-11-22 |