| NPI | 1184981938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 8463203-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA156975) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2023-02-06 |