| NPI | 1174510838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002304) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 1066424) |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2025-07-15 |