| NPI | 1033293816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06274) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA MA052743) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-07-21 |