| NPI | 1528708500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15619) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008847) |
| 363A00000X Physician Assistant (Licence: GA 10865) | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-08-15 |