| NPI | 1497132898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC473) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108655) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2021-08-17 |