| NPI | 1831648013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12298680-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06770) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2021-12-10 |