| NPI | 1528339918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200509) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00230) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA08214) | |
| 363AM0700X Physician Assistant, Medical (Licence: LA PA.200509) | |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2021-10-11 |