| NPI | 1093165318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13057) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2033) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2020-09-24 |