| NPI | 1417960907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12212) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 085002736) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2019-06-18 |