| NPI | 1467526723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC114) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1385) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2022-02-11 |