| NPI | 1689222739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10520109-1206) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 10520109-3501) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2023-09-07 |