| NPI | 1093171704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11260) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2587) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2021-07-08 |