| NPI | 1417612227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA19556) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 225200000X Physical Therapy Assistant (Licence: MD A5249) | |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2025-10-27 |