| NPI | 1336652833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13008) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8588) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2021-08-27 |