| NPI | 1427165836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03219) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 41808) |
| 183500000X Pharmacist (Licence: MI 5302026024) | |
| 363A00000X Physician Assistant (Licence: MI 5601002364) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-05-23 |