| NPI | 1588905061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2290) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA09240) |
| 363AM0700X Physician Assistant, Medical (Licence: TN 2290) | |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2022-07-20 |