| NPI | 1497802359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56830) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: HI AMD624) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-12-07 |