| NPI | 1821645961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3946) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC868) |
| 363A00000X Physician Assistant (Licence: KY PA2535) | |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2023-07-19 |