| NPI | 1053041897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004469A) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: TX PA15979) | |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2024-07-29 |