| NPI | 1124459227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09754) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006205) |
| 363A00000X Physician Assistant (Licence: LA PA.200685) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA.60785224) | |
| Enumeration Date | 2013-11-29 |
| Last Update Date | 2024-08-15 |