| NPI | 1003066796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14913) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012734-1) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2023-06-07 |