| NPI | 1376528901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK PA1007) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107151) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2020-04-02 |