| NPI | 1366744682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003342) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2015-02-27 |