NPI | 1750036406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6044) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3005) |
363A00000X Physician Assistant (Licence: KY TC185) | |
Enumeration Date | 2022-02-21 |
Last Update Date | 2024-07-18 |