| NPI | 1548301179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA16250) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116609) |
| 363AM0700X Physician Assistant, Medical (Licence: CO 847) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-11-22 |