| NPI | 1407535685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC154) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004124A) |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2024-08-01 |