| NPI | 1013912609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05248) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 359) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2017-02-21 |