| NPI | 1922280650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05277) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 010134) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2024-01-09 |