| NPI | 1912320763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10944) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004861) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2025-05-21 |