| NPI | 1164490710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 2809) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 2809) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2021-01-29 |