| NPI | 1023209483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA05631) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA-9102714) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2017-09-13 |