| NPI | 1003288648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1872) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10109) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2021-01-06 |