| NPI | 1235325382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053061) |
| Enumeration Date | 2007-09-22 |
| Last Update Date | 2012-12-06 |