| NPI | 1477223410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15117) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062917) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2021-12-01 |