| NPI | 1407438799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA065759) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 13000006-1206) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-08-28 |