| NPI | 1043662133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14794) |
| 363A00000X Physician Assistant (Licence: VA 0110011698) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2026-02-04 |