| NPI | 1366225336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02988) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2025006569) |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2025-04-18 |