| NPI | 1548413529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117935) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04965) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2024-06-18 |