| NPI | 1457434425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200247.RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA0528) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA0528) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2016-01-25 |