| NPI | 1114950359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA00956) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA pa10001357) |
| 363A00000X Physician Assistant (Licence: WA PA10001357) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2019-11-18 |