| NPI | 1457656704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7265) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 1991) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2016-04-18 |