| NPI | 1427649847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02708) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2022029878) |
| 363A00000X Physician Assistant (Licence: KS 15-02708) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2023-04-18 |