| NPI | 1881682581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA675) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10000576A) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2022-07-21 |