| NPI | 1609917004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18191) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8861) |
| 363A00000X Physician Assistant (Licence: MA 1429) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2024-09-17 |