| NPI | 1033177837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05376) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004943) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-08-02 |