| NPI | 1962187500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 5022) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1207850) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2023-10-06 |