| NPI | 1649057167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC031) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KY TC031) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-29 |