NPI | 1619286739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1601) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY PA1601) |
Enumeration Date | 2010-10-07 |
Last Update Date | 2022-06-30 |