| NPI | 1306570148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13818480-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: UT 13818480-8906) | |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2025-01-13 |