| NPI | 1598342214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12353304-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 12353304-8906) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2024-02-21 |