| NPI | 1730416025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 2394) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA-053986) |
| Enumeration Date | 2009-11-08 |
| Last Update Date | 2018-08-16 |