| NPI | 1134373491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07202) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01600) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2013-09-05 |