| NPI | 1336446616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0005370) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07201) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2018-10-25 |