| NPI | 1184214157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 324552) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14107) |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-01-22 |