| NPI | 1538494836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07345) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013586) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA MA054310) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA07345) | |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2020-10-30 |