| NPI | 1518674316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17835) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2024022554) |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2025-08-27 |