| NPI | 1912301540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002059A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC225) |
| 363A00000X Physician Assistant (Licence: OH 50.004170) | |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2024-02-26 |