| NPI | 1265550586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04363) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00242) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2023-09-06 |