| NPI | 1740573203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA17928) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6074) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2024-05-09 |