| NPI | 1245770452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 116462) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 12924) |
| 363A00000X Physician Assistant (Licence: SC 2712) | |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2023-02-28 |