| NPI | 1982746608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001524A) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2022-03-22 |