| NPI | 1093065302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA08777) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200558) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2014-02-09 |