| NPI | 1801337035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX 11194) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-05-04 |