| NPI | 1275979106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA15732) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05587) |
| Enumeration Date | 2013-05-19 |
| Last Update Date | 2024-03-12 |