| NPI | 1457890949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2017026356) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02001) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2024-04-30 |