| NPI | 1831253103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA1015) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08543) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2023-08-02 |