| NPI | 1083150874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA19010) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117570) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2025-09-05 |