| NPI | 1912484924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12226) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55711) |
| 363A00000X Physician Assistant (Licence: TN PA4649) | |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2024-03-25 |