| NPI | 1861284770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 14243840-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-09-17 |