| NPI | 1417647579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3248) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC400) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2023-09-25 |