| NPI | 1417611633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003404A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3218) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2024-02-13 |