| NPI | 1447685375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01639) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2013033101) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2018-12-06 |