| NPI | 1417315714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2926) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2021-02-01 |