| NPI | 1245242684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08666) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2010024509) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-09-16 |