| NPI | 1518239607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C02358) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07277) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2024-10-22 |