| NPI | 1457760811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001818A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY KY1927) |
| Enumeration Date | 2014-08-10 |
| Last Update Date | 2015-06-03 |