| NPI | 1821048679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA926) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA926) |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA926) | |
| 225100000X Physical Therapist (Licence: KY 001940) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-03-19 |