| NPI | 1609286004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 4159) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 3225) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA08931) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-05-23 |