| NPI | 1174945166 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA10587) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04692) | 
| Enumeration Date | 2014-01-10 | 
| Last Update Date | 2016-12-01 |