| NPI | 1538325824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2509) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04251) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9108038) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 001004251) | |
| 363AM0700X Physician Assistant, Medical (Licence: WV 01365) | |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA2509) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA2509) | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2020-08-24 |