| NPI | 1730730516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC866) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY TC866) |
| 363AM0700X Physician Assistant, Medical (Licence: KY TC866) | |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2020-10-27 |