| NPI | 1124356597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08091) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001002094) |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2022-10-17 |