| NPI | 1891204442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10550) |
| 363A00000X Physician Assistant (Licence: MI 5601008530) | |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2023-01-25 |