| NPI | 1023360237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA10222) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 1085) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2015-11-23 |