| NPI | 1750129185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA19119) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 11130) |
| 363A00000X Physician Assistant (Licence: OK 5390) | |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2025-07-31 |