| NPI | 1417167321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02528) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001984) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2016-01-28 |