| NPI | 1467953174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00372) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA18193) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2024-08-29 |