| NPI | 1124094859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OK 1032) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: KS 15-00943) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2024-06-12 |