| NPI | 1578713392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01287) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS T02322) |
| 363A00000X Physician Assistant (Licence: CA PA20474) | |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2014-06-17 |