| NPI | 1376422295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3825) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.009629RX) |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2026-03-20 |