| NPI | 1578215521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12658135-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 12658125-1206) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2024-02-23 |