| NPI | 1376871350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09734) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA09734) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 4509) | |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2023-08-11 |