| NPI | 1366802548 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11027) | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 11273906-4810) | 
| 363A00000X Physician Assistant (Licence: TX PA16950) | |
| 363A00000X Physician Assistant (Licence: UT 11273906-1206) | |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 11027) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-01 | 
| Last Update Date | 2025-08-18 |