| NPI | 1417719402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2025040852) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 1503254) |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2026-07-18 |