| NPI | 1588746937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 4930337-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052076) |
| 363A00000X Physician Assistant (Licence: DE C5-0000485) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2023-10-03 |