| NPI | 1346951811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 5210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007680) |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2024-06-18 |