| NPI | 1104482066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8424) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12728) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2021-11-09 |