| NPI | 1164572467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: TX 634) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 004340) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2021-01-11 |