| NPI | 1891231841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12256723-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9110060) |
| 363A00000X Physician Assistant (Licence: WA PA60731548) | |
| Enumeration Date | 2017-01-15 |
| Last Update Date | 2026-03-30 |