| NPI | 1548581697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06559) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60178663) |
| 363A00000X Physician Assistant (Licence: WA PA60178663) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2025-11-11 |