| NPI | 1982845863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK PA 2666) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2016-04-12 |