| NPI | 1871629279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10699) |
| 363A00000X Physician Assistant (Licence: TN 1481) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2023-09-18 |