| NPI | 1457012155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3189) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2023-09-07 |