| NPI | 1811633233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022038996) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15559) |
| 363A00000X Physician Assistant (Licence: KS 1502686) | |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2026-04-27 |