| NPI | 1578118774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18034) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010390) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2024-11-06 |