| NPI | 1114034527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 102307) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA00033) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2011-10-13 |