| NPI | 1174184121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17013) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007486) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2023-09-27 |