| NPI | 1326361882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6103) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06645) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA06645) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA06645) | |
| 363A00000X Physician Assistant (Licence: CO PA.0006174) | |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2020-08-11 |