| NPI | 1447482625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: KS 15-01341) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS T-02573) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2025-07-10 |