NPI | 1003571324 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02559) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-11-02 |
Last Update Date | 2022-01-29 |