| NPI | 1609046416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK PA1682) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK PA1682) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2019-02-14 |