| NPI | 1235658014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-03132) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA6213) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2025-09-29 |