| NPI | 1598218463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005464) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2025-06-16 |