| NPI | 1043702012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17062) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 308912) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-02-19 |