| NPI | 1508449976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13031316-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA214256) |
| 363A00000X Physician Assistant (Licence: UT 13031316-8906) | |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2024-10-03 |