| NPI | 1588842678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS T-01762) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01229) |
| 363A00000X Physician Assistant (Licence: MO 2022029622) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2022-11-08 |