| NPI | 1194759134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: OK PA772) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 772) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-05-12 |