| NPI | 1669126223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16856) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant (Licence: MI 5601010976) | |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2023-06-05 |