| NPI | 1083869630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2307) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05903) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2024-03-06 |