| NPI | 1841914967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02920) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 63810) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2025-02-27 |