| NPI | 1265754121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA14878) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 5771) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2021-09-09 |