| NPI | 1417948530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03435) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01455) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA03435) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2023-08-22 |