| NPI | 1407366230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA11483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004650A) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2024-12-16 |