| NPI | 1568086692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 3219) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07583) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2025-10-15 |