| NPI | 1902289218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02924) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2024023295) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2024-08-07 |