| NPI | 1730638800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18554) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2025-03-06 |