| NPI | 1689948176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 8350084-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03314) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2021-11-17 |