| NPI | 1558512996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: UT 10673585-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO 2690) |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2019-04-16 |