| NPI | 1275909483 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16659) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005579) | 
| Enumeration Date | 2015-08-11 | 
| Last Update Date | 2023-03-28 |