| NPI | 1952636516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02415) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06440) |
| 363AM0700X Physician Assistant, Medical (Licence: TX TX Temporary) | |
| 363AM0700X Physician Assistant, Medical (Licence: KS 15-02415) | |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2022-02-16 |