| NPI | 1790049211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1622) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: KY PA1622) |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA1622) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA1622) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2022-11-11 |