| NPI | 1659518165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1337) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1686) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2023-06-09 |