| NPI | 1649257353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05428) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000957) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2013-11-13 |