| NPI | 1689666026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1502098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 803) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2024-02-15 |