| NPI | 1548448087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 1724) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01282) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2022-01-27 |