| NPI | 1578663183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01712) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 107) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2014-09-04 |