| NPI | 1508316647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2613) |
| 363A00000X Physician Assistant (Licence: MO 2018004237) | |
| 363A00000X Physician Assistant (Licence: AZ 7448) | |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2023-05-10 |