| NPI | 1992320311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02594) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2022-05-12 |