| NPI | 1194059006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08449) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01429) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2021-04-19 |