| NPI | 1093063380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8327) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA07823) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2025-05-14 |