| NPI | 1366509135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA11798) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9101451) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-11 |