NPI | 1598389421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4612) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2718) |
363A00000X Physician Assistant (Licence: KY TC960) | |
363AM0700X Physician Assistant, Medical (Licence: KY PA2718) | |
363AS0400X Physician Assistant, Surgical (Licence: TN 4612) | |
363AS0400X Physician Assistant, Surgical (Licence: KY TC960) | |
Enumeration Date | 2020-06-06 |
Last Update Date | 2022-03-31 |