| NPI | 1992785786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 1500478) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 110581) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2010-02-15 |