| NPI | 1396498770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18043) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8560) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2026-03-16 |