| NPI | 1538318506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10589537-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4235) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2023-06-27 |