| NPI | 1902841919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA00448) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10002369A) |
| 363A00000X Physician Assistant (Licence: WY TL469) | |
| 363A00000X Physician Assistant (Licence: FL PA2364) | |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110004634) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2024-02-23 |