| NPI | 1134372261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9104739) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06250) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2014-03-10 |