| NPI | 1740796606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2859) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 5629) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2019-06-27 |