| NPI | 1932217296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 150475) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2018035240) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2021-11-23 |