| NPI | 1316316045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0005898) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 11200) |
| 363A00000X Physician Assistant (Licence: TX PA17445) | |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2024-02-29 |