| NPI | 1639636699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114326) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12395) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2024-07-22 |