| NPI | 1619488905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059152) |
| 363A00000X Physician Assistant (Licence: CA PA56260) | |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2025-01-13 |