| NPI | 1124330816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08455) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2580-023) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2022-04-12 |