| NPI | 1336422054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01522) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS T-03162) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2021-03-23 |