| NPI | 1255727731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT UT10846260-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2024-02-22 |