| NPI | 1750367488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA02777) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C11-0000001) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA063269) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2025-02-18 |