| NPI | 1568732618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA1887) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2075) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2024-03-13 |