| NPI | 1013082205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AR PA-355) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK PA1498) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2009-01-08 |