| NPI | 1477902930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02753) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53453) |
| 363A00000X Physician Assistant (Licence: MO 202301778) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2024-05-02 |