| NPI | 1700374493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021995-1) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2021-10-18 |