| NPI | 1881661015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 1174) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 1174) |
| 207R00000X Internal Medicine (Licence: OK 1174) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2021-11-19 |