| NPI | 1457870248 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16505)  | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00445300)  | 
| Enumeration Date | 2017-09-13 | 
| Last Update Date | 2023-11-08 |