| NPI | 1184713745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02314) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA02314) |
| 207P00000X Emergency Medicine (Licence: TX PA02314) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2009-10-05 |