| NPI | 1124644182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 11959125-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA2437) |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2021-06-02 |