| NPI | 1427454487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC194) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 004105) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2022-05-17 |