| NPI | 1184817371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08653) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01233) |
| 363A00000X Physician Assistant (Licence: SC 1788) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2024-11-18 |