| NPI | 1972816346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA 60107722) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2015-05-12 |