| NPI | 1457721854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11840) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9108924) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2019-03-20 |