| NPI | 1295036440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 5356) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06803) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2024-02-12 |