| NPI | 1124720107 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17997) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-1169) | 
| Enumeration Date | 2023-03-21 | 
| Last Update Date | 2025-04-21 |