| NPI | 1093780553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TX PA02177) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX PA02177) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2019-04-25 |