| NPI | 1073599106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 14067967-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 3052) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2024-07-12 |