| NPI | 1891214755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3823) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2017-0093) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2026-04-13 |