| NPI | 1356173041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025004014) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1503050) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2025-03-10 |