| NPI | 1588256150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17632) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008165) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2024-06-27 |