| NPI | 1548691256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1870) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001598A) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2023-08-15 |