| NPI | 1629759238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9423621-1206) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 9423621-3501) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-06-13 |