| NPI | 1306375449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-03275) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 8256) |
| Enumeration Date | 2017-06-11 |
| Last Update Date | 2026-06-17 |