| NPI | 1497209365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2157) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC501) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2025-08-07 |