| NPI | 1336709070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15243) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MA 7417) |
| Enumeration Date | 2019-06-15 |
| Last Update Date | 2024-08-20 |