| NPI | 1093963928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12775) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA 055096) |
| 363A00000X Physician Assistant (Licence: NY 012426-1) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA003037) | |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2023-04-21 |