| NPI | 1194863050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04619) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04819) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2012-02-13 |