| NPI | 1730660796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 11486995-1206) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA 60997904) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2023-08-01 |