| NPI | 1093700858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA07353) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085002384) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2016-12-20 |