| NPI | 1558487363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK PA1636) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA03667) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-04-08 |