| NPI | 1831082361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC113) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC113) |
| 363AS0400X Physician Assistant, Surgical (Licence: KY TC113) | |
| 207R00000X Internal Medicine (Licence: KY 1213019) | |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-09-05 |