| NPI | 1942755699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA2167) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY applied) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2021-01-21 |