| NPI | 1811589351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC091) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006602RX) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2024-01-08 |