| NPI | 1528781416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TX PA16180) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2025-08-27 |