| NPI | 1740727445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15925) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2193) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2022-10-05 |