| NPI | 1417159179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 1751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002908) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2008-08-12 |