| NPI | 1598068355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056209) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003121) |
| 363A00000X Physician Assistant (Licence: TX PA06933) | |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2020-12-24 |