| NPI | 1902360472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12490) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006497) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2022-11-10 |