| NPI | 1174847156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06661) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA-3258) |
| Enumeration Date | 2010-03-20 |
| Last Update Date | 2013-01-29 |