| NPI | 1235987983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12320) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17895) |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-05-08 |