NPI | 1568820629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA2076) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 2927) |
Enumeration Date | 2016-02-04 |
Last Update Date | 2023-12-08 |