| NPI | 1770250680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18310) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1185916) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2025-07-29 |