| NPI | 1477654093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: UT 200819-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NV PA1411) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2018-06-13 |