| NPI | 1073847034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01326) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2574) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2023-03-30 |