| NPI | 1104221969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13175) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2420) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2019-11-22 |