| NPI | 1780148361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13556) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023363) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2023-07-31 |