| NPI | 1952878472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 4390) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA12364) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2022-06-22 |