| NPI | 1881850659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01696) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-326) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2019-01-27 |