| NPI | 1437228210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01202) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10000904A) |
| 363AM0700X Physician Assistant, Medical (Licence: OK 1860) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2010-01-20 |