| NPI | 1578573937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 1339) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA0478) |
| 363AM0700X Physician Assistant, Medical (Licence: IA 002043) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2015-10-05 |