| NPI | 1437523875 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 9565367-1206) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 9565367-1206) | 
| Enumeration Date | 2015-11-23 | 
| Last Update Date | 2024-10-14 |