| NPI | 1376132167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15647) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006835) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2024-07-03 |