| NPI | 1982274254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3351) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5231) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2024-06-06 |