| NPI | 1275197980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-13624) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13745) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA13745) | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2024-01-16 |