| NPI | 1528412459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA2089) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC477) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-11-18 |