| NPI | 1649564964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 311571) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA7387) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2025-07-17 |