| NPI | 1184273286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 1502313) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1502313) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2020-02-20 |