| NPI | 1922884634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC083) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004115A) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2023-11-22 |