| NPI | 1467692467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9745429-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2008) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2017-10-24 |