| NPI | 1740467802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01478) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1367) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2022-04-23 |