| NPI | 1730197088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: KY PA-045) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA-045) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2019-04-18 |