| NPI | 1487868923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1501163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2007006942) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2016-11-22 |