| NPI | 1154137560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02994) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2024043492) |
| 363A00000X Physician Assistant (Licence: IL 085.010734) | |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2025-09-18 |