| NPI | 1588962773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA0309) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07164) |
| 363A00000X Physician Assistant (Licence: TX PA07164) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NV PA0309) | |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2015-06-17 |