| NPI | 1609838507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK PA1866) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OK 1333) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2015-11-13 |