| NPI | 1487925715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2281) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07522) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2013-07-24 |