| NPI | 1215908322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 126394-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA846) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2021-09-15 |