| NPI | 1851866735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10970425-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 10970425-1206) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2025-09-08 |