NPI | 1154048387 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02841) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK 4869) |
Enumeration Date | 2022-10-27 |
Last Update Date | 2024-09-12 |