| NPI | 1407302466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13928) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020034) |
| 363A00000X Physician Assistant (Licence: TN 3596) | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2022-07-01 |