| NPI | 1538512967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2354) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA2354) | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2022-11-15 |