| NPI | 1194255182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2019014003) |
| 363A00000X Physician Assistant (Licence: KS Pending) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2021-06-02 |