| NPI | 1912581620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9278723-1206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 9278723-1206) |
| 363AM0700X Physician Assistant, Medical (Licence: UT 9278723-1206) | |
| Enumeration Date | 2021-05-09 |
| Last Update Date | 2023-09-08 |