| NPI | 1104624147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA20371) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 000630280) |
| Enumeration Date | 2025-03-05 |
| Last Update Date | 2026-05-19 |