| NPI | 1033519525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110005173) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09298) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2024-05-09 |