| NPI | 1598061434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02940) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4083) |
| 363A00000X Physician Assistant (Licence: MO 2020025176) | |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2024-08-08 |