| NPI | 1952876427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2423) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3908) |
| 363A00000X Physician Assistant (Licence: KY TC763) | |
| 363A00000X Physician Assistant (Licence: IN 10003177A) | |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-06-30 |