| NPI | 1215943055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04742) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006277) |
| 363A00000X Physician Assistant (Licence: CO PA-2849) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-05-15 |