| NPI | 1396221602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15341) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022245) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2022-07-27 |