| NPI | 1679687719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 6111) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 57987) |
| 363A00000X Physician Assistant (Licence: TX PA02541) | |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA02541) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2025-06-09 |