| NPI | 1982076121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01864) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: KS 15-01864) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2024-09-11 |