| NPI | 1194359539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024035203) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1503004) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2025-10-06 |