| NPI | 1851932727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14532) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: FL PA9112659) | |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2021-06-25 |