| NPI | 1407046675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 7181236-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ T669) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2024-02-06 |