| NPI | 1760713390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2210) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2018-12-05 |