| NPI | 1114140910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA1727) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA01197) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA 03869) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2022-10-20 |