| NPI | 1174041578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 279726-1206) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2018-11-07 |