| NPI | 1215509468 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15382) | 
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX PA15832) | 
| 207Y00000X Otolaryngology (Licence: TX PA15382) | |
| Enumeration Date | 2021-07-15 | 
| Last Update Date | 2025-01-13 |