| NPI | 1265907372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12381) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2019-03-04 |