| NPI | 1972179471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02546) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2025001373) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2025-07-31 |