| NPI | 1861102725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13224762-1206) |
| Additional Taxonomies | 208800000X Urology (Licence: UT 13224762-1206) |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2023-06-09 |