| NPI | 1578299475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18243) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116209) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2024-10-09 |