| NPI | 1295107118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 4520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2125) |
| 363A00000X Physician Assistant (Licence: LA PA.200882) | |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2022-02-14 |