| NPI | 1194775981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2964) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07314) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-11-15 |