| NPI | 1447901681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1502779) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 1906) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2023-10-17 |