| NPI | 1801375654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8083) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12132) |
| 363A00000X Physician Assistant (Licence: FL PA9111390) | |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2020-10-14 |