| NPI | 1205892221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA01734) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX tx01734) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA01734) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2013-02-26 |