| NPI | 1558008714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 13618579-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2023-10-19 |