| NPI | 1285633511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TX PA01245) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058445) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-02-20 |