| NPI | 1023501434 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12236) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2018-06-11 | 
| Last Update Date | 2020-10-26 |