| NPI | 1881866689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2455) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002712RX) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2024-10-25 |