| NPI | 1023562212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11040) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0006793) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2025-08-01 |