| NPI | 1811372626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14324) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007409) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2021-09-14 |