| NPI | 1497099709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07657) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12411) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2023-06-06 |