| NPI | 1669104055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024025125) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02951) |
| Enumeration Date | 2022-06-26 |
| Last Update Date | 2024-10-18 |