| NPI | 1548547276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003687) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08896) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2022-12-16 |