| NPI | 1710443544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-930) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13490) |
| 363A00000X Physician Assistant (Licence: OK 4823) | |
| Enumeration Date | 2019-02-17 |
| Last Update Date | 2022-12-14 |