| NPI | 1619947744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-00506) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 1500506) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-10-29 |