| NPI | 1154972958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024014049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 3136) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2024-11-06 |