| NPI | 1497474076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2022015276) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2022-08-25 |