| NPI | 1164758959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055985) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06245) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2021-03-04 |