| NPI | 1669540969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10002510A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06846) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2021-04-06 |