| NPI | 1881246130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 11907746-1206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11907746-1206) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2021-10-19 |