| NPI | 1336420561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-01479) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2015010264) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2022-10-03 |