| NPI | 1679909006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15999) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 017002) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60668491) | |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2026-04-27 |