| NPI | 1275801821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02921) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2024028490) |
| Enumeration Date | 2011-12-11 |
| Last Update Date | 2024-08-27 |