| NPI | 1417315839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-01872) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2017042994) |
| Enumeration Date | 2016-01-30 |
| Last Update Date | 2024-07-18 |