| NPI | 1326390964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9631951-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 5260) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2024-02-03 |