| NPI | 1144254855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 3310) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN 1928) |
| 363AM0700X Physician Assistant Medical (Licence: TX PA04610) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-05-29 |