| NPI | 1265594691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA 04120) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 010265) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2017-05-09 |