| NPI | 1235721069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2020007088) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02883) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2024-03-08 |