| NPI | 1235692112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02445) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2366) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-10-17 |