| NPI | 1194418467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16929) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 1207675) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2023-09-01 |