| NPI | 1417395351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09843) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200620) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-05-05 |