NPI | 1386647261 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA839) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-00-2067) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2007-07-08 |