| NPI | 1841151693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-03252) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2026005535) |
| Enumeration Date | 2025-11-20 |
| Last Update Date | 2026-03-20 |