| NPI | 1043976657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17146) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9115074) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2023-11-28 |