| NPI | 1841676145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00379400) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2022-10-31 |