| NPI | 1568778116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08180) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 1951) |
| 363A00000X Physician Assistant (Licence: NE 2116) | |
| 363A00000X Physician Assistant (Licence: MI 5601003549) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2025-09-09 |