| NPI | 1851608418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01905) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4688) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2017-01-22 |