| NPI | 1003126061 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA08073) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004335) | 
| Enumeration Date | 2010-10-08 | 
| Last Update Date | 2025-10-08 |