| NPI | 1730140484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9060898-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10000690A) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2023-11-27 |