| NPI | 1710949755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-00278) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-01-29 |