| NPI | 1700202637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 3096) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01684) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2019-10-22 |