| NPI | 1134558034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10771) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107502) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2016-09-09 |