| NPI | 1750036406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3005) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC185) |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2023-10-31 |