NPI | 1386493310 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3439) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363A00000X Physician Assistant (Licence: KY TC188) | |
Enumeration Date | 2024-05-13 |
Last Update Date | 2025-01-09 |