| NPI | 1881843142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08414) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 013473-1) |
| 363A00000X Physician Assistant (Licence: CT 002122) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA08414) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2026-05-28 |