| NPI | 1275924342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018423) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2019-11-21 |