| NPI | 1356629109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1649) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 13590) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2026-03-02 |