| NPI | 1215446075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14284) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07593) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2021-04-08 |