| NPI | 1649821281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 7543507-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7570) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2024-09-17 |