| NPI | 1104056399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 4842) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06244) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2023-02-16 |