| NPI | 1922515535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002508A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA0000) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2018-10-23 |