| NPI | 1598823825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 11427316-1206) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3521) |
| 363A00000X Physician Assistant (Licence: AZ 3521) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KS 15-01213) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2024-09-16 |