| NPI | 1245886670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1502235) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12884) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2020-03-04 |