| NPI | 1881305837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3688) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 1206650) |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA3688) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA3688) | |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2025-10-07 |