| NPI | 1891869210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK PA1573) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA18067) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2012-07-24 |