| NPI | 1295376523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK 4722) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2022-01-04 |