| NPI | 1023752896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 11987213-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026385) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2024-02-05 |