| NPI | 1952918245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17108) |
| Additional Taxonomies | 2086S0129X (Licence: LA 323729) |
| 363A00000X Physician Assistant (Licence: LA 323729) | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2023-10-27 |