| NPI | 1770155566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12017) |
| 363A00000X Physician Assistant (Licence: KY TC004) | |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2024-10-31 |