| NPI | 1740807379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02704) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2022048966) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2025-04-22 |