| NPI | 1255711768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01890) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2025-05-30 |