| NPI | 1821672163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 10968079-1206) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363AM0700X Physician Assistant, Medical (Licence: UT 10968079-8906) | |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2025-10-23 |