| NPI | 1326800574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02895) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2024004731) |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2026-01-27 |