| NPI | 1619314085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01601) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2013007991) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007987) | |
| Enumeration Date | 2013-05-25 |
| Last Update Date | 2023-11-21 |