| NPI | 1538565650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2314) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1929) |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA1929) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA1929) | |
| 363A00000X Physician Assistant (Licence: KY TC336) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2022-09-23 |