| NPI | 1336617679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17449) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 310468) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2024-01-17 |