| NPI | 1497718357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1500498) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 1500498) |
| 363A00000X Physician Assistant (Licence: MO 2021021597) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2024-04-30 |