| NPI | 1518072586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 1831) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04385) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-05-11 |