| NPI | 1700523271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18587) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12441) |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2025-01-08 |