| NPI | 1588855217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1809) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1036) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2016-11-17 |