| NPI | 1053721142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2517) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51534) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2020-09-14 |