| NPI | 1255216362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2026014421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1503262) |
| Enumeration Date | 2025-08-07 |
| Last Update Date | 2026-07-18 |