| NPI | 1649356619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA15461) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 010032) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2025-01-08 |