| NPI | 1609162007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18802) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4197) |
| 363AM0700X Physician Assistant, Medical (Licence: UT 13425718-1206) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2025-07-24 |