| NPI | 1932446424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2938) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016242) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2022-04-15 |