| NPI | 1285291955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 1502259) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 58625) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2022-02-07 |