| NPI | 1366719080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK PA5503) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA22003) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2024-12-26 |