| NPI | 1275081358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10746358-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0004775) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2023-11-27 |