| NPI | 1205310034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 3650) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2020-06-22 |