| NPI | 1598284978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12817) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005232RX) |
| Enumeration Date | 2017-09-16 |
| Last Update Date | 2024-11-01 |