| NPI | 1073081725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111793) |
| Enumeration Date | 2018-11-10 |
| Last Update Date | 2022-10-26 |