| NPI | 1144429473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11718) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2422) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2021-09-30 |