| NPI | 1336339712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13365972-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02647) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2023-05-12 |