| NPI | 1831124908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA819) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000944A) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-03-21 |