| NPI | 1356237135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS Pending) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2025015169) |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-06-17 |