NPI | 1518764430 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC038) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: KY TC038) |
363AS0400X Physician Assistant Surgical (Licence: KY TC038) | |
Enumeration Date | 2025-02-27 |
Last Update Date | 2025-05-09 |