| NPI | 1922507136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002662A) |
| 363A00000X Physician Assistant (Licence: UT 105674441206) | |
| Enumeration Date | 2018-02-03 |
| Last Update Date | 2023-04-19 |