| NPI | 1588738884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2005032625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01075) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2025-07-17 |