| NPI | 1598135808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: KS 1501842) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: KS 1501842) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2022-10-06 |