| NPI | 1710654173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 1031896) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-10-06 |