| NPI | 1912558271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 4527) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9121468) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2026-07-31 |