| NPI | 1467888636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 8797960-1206) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: UT 8797960-1206) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2024-07-02 |