| NPI | 1952776908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058865) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10171) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2017-04-03 |