| NPI | 1457558363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1501751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2016009737) |
| 363A00000X Physician Assistant (Licence: PA MA052791) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-06-10 |