| NPI | 1114279965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02876) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA160132) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2024-03-19 |