| NPI | 1407016306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 1748) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 05319) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2017-08-10 |