| NPI | 1053736017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16750) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 5313279-1206) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2023-12-01 |