| NPI | 1306554209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10771) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA16383) |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2025-05-30 |