| NPI | 1396028585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2013017433) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 1501489) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2025-08-19 |