| NPI | 1518950047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14793) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004351) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2021-12-20 |