| NPI | 1346513553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07560) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7672) |
| Enumeration Date | 2012-02-18 |
| Last Update Date | 2021-01-13 |