| NPI | 1770079774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA20376) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10002529A) |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical (Licence: OK 4789) | |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2026-07-07 |