| NPI | 1407367097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02071) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: KS 15-02071) | |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2021-03-25 |