| NPI | 1649899600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 14298) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 3181) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2022-09-23 |