| NPI | 1891533790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024028263) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17801) |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |