| NPI | 1114396777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009208) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09983) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2023-05-19 |