| NPI | 1801132964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY 2302) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 003649) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2022-11-10 |