| NPI | 1578988739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2015018862) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01807) |
| 363AM0700X Physician Assistant, Medical (Licence: OK 2347) | |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2022-02-10 |