| NPI | 1457300022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA06455) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50002427) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2011-11-21 |