| NPI | 1134511694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10777) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1892) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2025-03-17 |