| NPI | 1366729279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OK 2550) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IN 10001357A) |
| 363AM0700X Physician Assistant Medical (Licence: MO 2015007864) | |
| 363AM0700X Physician Assistant Medical (Licence: IL 085004016) | |
| Enumeration Date | 2011-11-05 |
| Last Update Date | 2019-08-29 |