| NPI | 1336145010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 1219) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA05050) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2022-12-29 |