| NPI | 1134531379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12067) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4990) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2019-03-11 |