| NPI | 1154944411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1502437) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2025-01-23 |