| NPI | 1972833085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TX PA06635) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2025-08-06 |