| NPI | 1972176832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: TX PA14774) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX PA14774) | |
| 363A00000X Physician Assistant (Licence: VA 0110-008764) | |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2026-06-03 |