| NPI | 1831841055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02902) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MO 2022048909) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA 60623) | |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2025-02-02 |