| NPI | 1912591124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-03001) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01312) |
| 363A00000X Physician Assistant (Licence: MO 2024045400) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-02-28 |
| Last Update Date | 2025-06-20 |