| NPI | 1326348160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001002483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2697) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2022-06-17 |