| NPI | 1861632143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA4709) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06751) |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA20233) | |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2019-06-17 |