| NPI | 1538726997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1742) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: OK 3073) | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2023-03-31 |