| NPI | 1851826077 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15717) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9110270) | 
| Enumeration Date | 2017-04-25 | 
| Last Update Date | 2023-09-14 |