| NPI | 1407363633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10654521-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005502) |
| 363A00000X Physician Assistant (Licence: UT 10654521-8906) | |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2023-06-01 |