NPI | 1477063790 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC651) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TC651.) |
Enumeration Date | 2017-10-02 |
Last Update Date | 2022-07-25 |