| NPI | 1225021058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 1741) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA05179) |
| 363AM0700X Physician Assistant, Medical (Licence: SD 0591) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2020-04-21 |