| NPI | 1457865370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA3011) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 3443) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2026-07-27 |