| NPI | 1154071546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17090) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 4814) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2024-07-18 |