NPI | 1477226215 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2897) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC150) |
Enumeration Date | 2021-07-28 |
Last Update Date | 2022-01-05 |