| NPI | 1538261060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2119) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01093) |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2017-06-13 |