| NPI | 1477835494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA1672) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC052) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2023-06-16 |