| NPI | 1710271556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1501443) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 1931) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2016-02-11 |