| NPI | 1295154516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10148) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1789) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-08-30 |