| NPI | 1811331994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4029) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08344) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2022-07-21 |