| NPI | 1912309766 |
|---|---|
| Former Name | CHRISTINA PENICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1971) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC345) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2018-09-11 |