| NPI | 1366155699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025036989) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02889) |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2025-11-07 |