NPI | 1720736648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3087) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363AM0700X Physician Assistant, Medical (Licence: KY PA3087) | |
363AS0400X Physician Assistant, Surgical (Licence: KY PA3087) | |
Enumeration Date | 2022-03-10 |
Last Update Date | 2024-04-05 |