| NPI | 1851793178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 9146360-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 9146360-8906) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2021-11-08 |