| NPI | 1023646692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-03067) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA 1170802) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-06-10 |