| NPI | 1427100353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2010002166) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01266) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2024-08-13 |