| NPI | 1649571076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1909) |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2019-08-02 |