| NPI | 1366424863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1294) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-00317) |
| 363A00000X Physician Assistant (Licence: IA 1875) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2013-07-10 |