| NPI | 1467874065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13528) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6411) |
| 363A00000X Physician Assistant (Licence: NY 23 015774) | |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2020-08-04 |