| NPI | 1134599368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05940) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10939) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2024-09-19 |