| NPI | 1952092769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02808) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2023034169) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2024-04-02 |