| NPI | 1194148031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD c0005270) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX pa03540) |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2014-01-29 |