| NPI | 1194061143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2188) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK APA2188) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2022-06-08 |