| NPI | 1639843840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14652) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60808) |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2025-08-12 |