| NPI | 1962874446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13578492-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6256) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2026-04-29 |