| NPI | 1053542712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10769) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013274-1) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2019-03-12 |