| NPI | 1396749081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NV PA1594) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TX PA03538) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2017-10-24 |