| NPI | 1174241251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: OK 5421) | |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2024-12-16 |