| NPI | 1396986360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002964) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08123) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2025-09-15 |