| NPI | 1740619899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2544) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2014) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2015-11-30 |