| NPI | 1457030371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 14229959-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13511) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2025-07-22 |