| NPI | 1487913612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10001379A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC642) |
| 363AM0700X Physician Assistant, Medical (Licence: KY TC642) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2018-09-28 |