| NPI | 1356963771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 11965136) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY PA907) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2023-03-14 |