| NPI | 1801899018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 530) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01243) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2010-02-23 |