| NPI | 1689651986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07031) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA00774) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA07031) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA10003761) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2024-07-30 |