| NPI | 1285071209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16910) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52617) |
| 363A00000X Physician Assistant (Licence: NY 024918) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2024-09-09 |