| NPI | 1467450858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY PA353) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA 353) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2009-06-11 |