| NPI | 1730293978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA-604) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10000542A) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2025-06-06 |