| NPI | 1043028335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-03052) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2025010280) |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2025-04-03 |