| NPI | 1659446474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09769) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002365) |
| 363A00000X Physician Assistant (Licence: WA PA60099489) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2023-08-31 |