| NPI | 1063472215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA00539) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50002282) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2012-12-11 |