| NPI | 1184875635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1727) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05435) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2018-06-13 |