| NPI | 1093447716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 16685) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 390200000X) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2023-05-04 |