| NPI | 1801401344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13444599-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2024-11-19 |