| NPI | 1437541893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01853) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2015005495) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2022-01-04 |