| NPI | 1619502457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003343A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2868) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2025-03-27 |