| NPI | 1487095964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1711) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1501623) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2020-04-06 |