| NPI | 1467183038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02687) |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine (Licence: KS 15-02687) |
| 207QA0505X Family Medicine Adult Medicine (Licence: KS 15-02687) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-08-25 |