| NPI | 1427635507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2810) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC067) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2021-09-22 |