| NPI | 1609559376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3373) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC106) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2024-03-22 |