| NPI | 1194166850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08532) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: AR PA-923) | |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2024-01-04 |