| NPI | 1467696583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA08429) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013242-1) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2017-12-26 |