| NPI | 1568003655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14668) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007332) |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2023-08-11 |