| NPI | 1881756443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13466) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011022) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2022-01-11 |