| NPI | 1750415691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1117) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1118) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2023-03-07 |