| NPI | 1083633846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1097) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01249) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-03-07 |