| NPI | 1245929249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA20393) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA64348) |
| 363A00000X Physician Assistant (Licence: NC 0010-12904) | |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2026-07-27 |