| NPI | 1366803488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 126726) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA10507) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2025-07-03 |