| NPI | 1073869848 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA7443) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA19130) | 
| Enumeration Date | 2012-07-31 | 
| Last Update Date | 2025-06-23 |