| NPI | 1861889222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05712) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA10033) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05712) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2019-07-09 |