| NPI | 1811223084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12084) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA11208) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2022-06-10 |