| NPI | 1174561237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01030) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 117957) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2009-11-20 |