| NPI | 1760618730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10561256-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2018-03-17 |