| NPI | 1720096498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2383) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03347) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-08-29 |