| NPI | 1750464541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA162761) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03201) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-05-16 |