| NPI | 1417371691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1884) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC258) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2020-12-01 |