| NPI | 1265440515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08513) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003164) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-03-07 |