| NPI | 1215207667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03561) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK 2064) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2014-06-13 |