| NPI | 1083808422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09301) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085003011) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2026-07-24 |