| NPI | 1467914481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 310465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14547) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-03-20 |