| NPI | 1659757227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011612) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09820) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2021-11-11 |