| NPI | 1962732610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 1883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 1883) |
| 363A00000X Physician Assistant (Licence: OK 1883) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2021-06-21 |