| NPI | 1053877258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12677) |
| 363A00000X Physician Assistant (Licence: MO 2022006989) | |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2023-10-25 |