| NPI | 1174267314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15865) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4986) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-07-14 |