| NPI | 1598748386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1500738) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 1047745) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2025-10-02 |