| NPI | 1235907254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA17589) |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-03-27 |