| NPI | 1770773715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS KS15-01578) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR P-T0713) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2021-06-24 |