NPI | 1801083746 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY PA785) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: KY PA785) |
363A00000X Physician Assistant | |
Enumeration Date | 2007-09-25 |
Last Update Date | 2021-04-27 |