| NPI | 1619604386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16033) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX pending) |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-12-28 |