| NPI | 1093011280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07767) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4802) |
| 363AM0700X Physician Assistant, Medical (Licence: OK 2390) | |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2019-05-17 |