| NPI | 1447487780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2009019847) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01311) |
| Enumeration Date | 2009-06-13 |
| Last Update Date | 2022-01-04 |