| NPI | 1982374989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18291) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 11477) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2025-08-15 |