| NPI | 1720608557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA16569) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.008002) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2024-09-17 |