| NPI | 1831649508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12364386-1206) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2021-09-24 |