| NPI | 1013725803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025009771) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-03181) |
| Enumeration Date | 2024-12-25 |
| Last Update Date | 2026-02-26 |