| NPI | 1669105961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101332) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA15889) |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2025-05-07 |