| NPI | 1447277462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12424) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 548) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 548) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-03-13 |