| NPI | 1760143606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2996) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC213) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2023-07-06 |