| NPI | 1912338872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10332057-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1659) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2022-10-27 |