| NPI | 1336162494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022041222) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1501223) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-02-24 |