| NPI | 1508406448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13775) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TX AT6579) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2023-10-18 |