| NPI | 1053466763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 1593) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2024022107) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085.010556) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2026-07-14 |