| NPI | 1730528118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10603) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA1811) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-11-12 |