| NPI | 1407187313 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14279) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013744-1) | 
| Enumeration Date | 2010-01-18 | 
| Last Update Date | 2023-09-18 |