| NPI | 1639849755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 13100576-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115034) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2023-06-07 |