| NPI | 1851625263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 7442564-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1615) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2025-09-13 |