| NPI | 1083824783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06266) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA1148) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2014-10-30 |