| NPI | 1154050003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02693) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: KS 15-02693) |
| 363AM0700X Physician Assistant, Medical (Licence: KS 15-02693) | |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2025-03-03 |