| NPI | 1982113296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11542) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006332) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2023-01-11 |