| NPI | 1316359300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024023425) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-563) |
| 363A00000X Physician Assistant (Licence: KS 1502925) | |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2024-07-10 |