| NPI | 1376631903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001505A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03855) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-10-19 |