| NPI | 1538644422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13752674-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060156) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2024-11-04 |