| NPI | 1356165062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-03042) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2026010844) |
| Enumeration Date | 2024-11-09 |
| Last Update Date | 2026-07-13 |