| NPI | 1649892357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14619) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2024-01-17 |