| NPI | 1588796767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108494) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA734) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2015-06-05 |