| NPI | 1356739486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2475) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 076350) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2020-02-13 |