| NPI | 1730454489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07669) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA60379339) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2023-05-05 |