| NPI | 1487096947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10409) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA-61580095) |
| 363A00000X Physician Assistant (Licence: PA MA066148) | |
| 363A00000X Physician Assistant (Licence: CA 63771) | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2025-03-24 |