| NPI | 1922259696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 5752) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1049) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2023-11-28 |