| NPI | 1821352865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1726) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2413) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2018-03-06 |