| NPI | 1568819902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 5871) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 3158) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2023-08-30 |