| NPI | 1518291913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09959) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06781) |
| 363A00000X Physician Assistant (Licence: PA MA-054149) | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2021-07-21 |