| NPI | 1417222951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX 0000) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA07774) |
| 363AM0700X Physician Assistant, Medical (Licence: NE 1627) | |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2021-11-06 |